VBS-Registration

Please fill out this form for each student attending Vacation Bible School!

* Required Fields

*Student Last Name:
*Student First Name:
*Street Address:
*Town:
*State:
*Zip code:
*Age:
Grade Completed:
*Allergies:
*Parents' Names:
*Parents Phone Number:
*E-mail Address:
*Confirm Email Address:
*Emergency Contact (Name and Telephone Number):
*Home Church (if any):
I understand that by attending VBS I give Living Proof Church permission to use photographs and/or video of my child for VBS crafts and promotion including print and our websites.
*Authentication:
*5 + 7 =	Enter the correct answer to the math question.
Please click the Send button only once.